Hospital and Extras Cover

There are two types of private health insurance cover: hospital cover and extras cover.

What is hospital cover?

Hospital cover is health insurance that covers your costs as a private patient in a public hospital, private hospital or day hospital facility, up to the MBS (Medicare Benefit Schedule) fee. The insurance covers your hospital accommodation, medical treatment (theatre, doctor and pharmacy fees), prostheses, and ambulance (in some states).

What is extras cover?

Extras cover, also referred to as general or ancillary cover, is insurance that offers benefits for day-to-day treatments often not covered by Medicare, including dental, physiotherapy and optical. Extras cover can also include podiatry, chiropractic, occupational therapy and alternative treatments like acupuncture, myotherapy and massage.

Hospital and extras packages

All funds offer policies that include cover for both hospital cover and extras. Generally, the more extensive your health cover, the higher your premium. When choosing your private health insurance fund, it’s important to ensure it suits both your needs and your budget.

Be aware

If you’re taking out health insurance cover for the first time, or you’re upgrading to a higher level of coverage, you could face a waiting period before you can claim benefits through your new plan. Make sure you inquire about waiting periods that will affect you. It’s important to note that some procedures, such as wisdom teeth removal, would require both hospital and extras cover as there is a hospital stay involved.

If transferring to a policy that has higher annual limits than your previous cover you will be required to serve the waiting period before receiving the additional annual limit.